HBV、HCV单项目反应性无偿献血者心理健康调查及干预策略

Psychological health survey and intervention strategies of HBV and HCV single-reagent nucleic acid reactive unpaid blood donors

目的调查乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)核酸和酶联免疫单项目反应性结果对无偿献血者心理行为状况的影响,探讨实施合理心理干预措施的必要性,以提高公众对无偿献血的信任度及避免献血者流失。方法选取在深圳市龙岗区中心血站2015~2018年HBV、HCV酶联免疫及核酸检测单项反应性被屏蔽的献血者,同意进行电话访谈及自制问卷调查的137位献血者为评估对象,根据首次评估结果对同意进行后续回访的92位献血者应用症状自评量表(SCL-90)以访谈形式进行心理调查,评估单项目血液检测屏蔽结果对献血者产生的心理影响,探讨实施合理心理干预措施的必要性及干预策略。结果在献血后回告过程中共有137位无偿献血者在电话回访时接受初步心理评估,大部分对专业人员专线答疑、相关知识家庭宣传小册和希望血站进行复检等有较强的需求。而同意进行SCL-90调查的92位献血者中,首次评估时除阳性症状项目外,抑郁、敌对、精神病性得分均低于全国常模,躯体症状、强迫、人际关系敏感、焦虑、偏执得分均高于全国常模,差异有统计学意义(P<0.05);心理干预后,献血者的人际关系敏感、焦虑、敌对得分均低于首次评估时,差异有统计学意义(P<0.05)。结论实施适当的心理干预措施对于缓解献血者的负面心理起积极作用;血清学酶联免疫联合核酸检测为临床输血安全提供了基本保障,但对单项反应性被屏蔽献血者应给予相应复检及归队指引;重视献血者心理诉求对保障血源及提高公众对无偿献血的认知与热情具有重要意义。

Objective To investigate the effect of hepatitis B virus(HBV)and hepatitis C virus(HCV)single-reagent nucleic acid and enzyme-linked immunoassay reactivity results on the psychological behavior status of unpaid blood donors,and explore the necessity of implementing reasonable psychological interventions to increase public trust in unpaid blood donation and avoid blood donor loss.Methods Blood donors whose HBV and HCV enzyme-linked immunoassays and nucleic acid tests were blocked in Longgang Blood Station of Shenzhen City from 2015 to 2018 were selected,and 137 among of them who agreed to conduct telephone interviews and self-made questionnaires were selected as the evaluation objects.Psychological survey was conducted in the form of interview with the self-rating symptom scale(SCL-90)and self-made questionnaire to evaluate the psychological impact of single item blood test screening results on 92 blood donors who agreed to follow-up visits and explore the necessity and intervention strategies of implementing rational psychological intervention measures.Results A total of 137 unpaid blood donors received a preliminary psychological evaluation during the telephone return visit after blood donation.Most of them had a strong demand for answering questions on professional hotline,publicity brochures for families with relevant knowledge and expecting blood stations to conduct reexamination.Among the 92 blood donors who agreed to conduct the SCL-90 survey,except for the positive symptoms,the scores of depression,hostility,and psychosis at the first evaluation were all lower than those of the national norm,and the scores of physical symptoms,compulsions,interpersonal sensitivity,anxiety,and paranoia were all higher than those of the national norm,the differences were statistically significant(P<0.05).After psychological intervention,the blood donors′interpersonal sensitivity,anxiety,and hostility scores were lower than those at the first evaluation,and the differences were statistically significant(P<0.05).Conclusion The implementation of appropriate psychological interventions has a positive effect on alleviating the negative psychology of blood donors.Serological enzyme-linked immunoassay combined with nucleic acid testing provides a basic guarantee for the safety of clinical blood transfusion,but single-reactivity blocked blood donors should be given corresponding re-inspection and return guidance.Paying attention to the psychological demands of blood donors is of great significance for protecting the blood source and enhancing the public′s awareness and enthusiasm for unpaid blood donation.